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Celiac Disease and Diabetes: Wheat Ails You?


Gluten-free Diets

19th Century Diet

One way to go gluten-free that is easy on your wallet and easy on your brain is to eat as if you're living in the 19th century. That is, eat no packaged food and don't eat at restaurants. Eat only whole foods that are cooked in your home. Eat plain vegetables, fruits, meat, fish, eggs, and rice. These foods are naturally gluten-free. Ideally, no gluten-containing foods would be prepared in your home during this time to avoid contamination of the food you eat.

20th Century Diet

If you can't see going without packaged foods, you've got a lot of reading ahead of you. You'll need to scrutinize lists of ingredients for any of the taboo grains or flours. You'll often find wheat or flour listed.

Assume nothing! Read all ingredient lists. One would think that Rice Chex cereal would be safe. But when you read the ingredients, you find it contains barley malt extract - not safe.

Beware of hidden gluten. Flavorings, colorings, and other additives may contain gluten. When checking ingredients, follow the rule: "Don't know? Don't eat."

Gluten that is part of the packaging isn't listed in the ingredients. For example, chewing gum wrappers may be dusted with flour.

For long lists of foods you can and can't eat, get books about celiac disease, or check out the Web sites listed below (search the keywords "celiac," "gluten," or "gastrointestinal"). You'll be surprised and perhaps overwhelmed at the number of foods and additives that you can't eat (caramel color, communion wafers, curry powder). You might then decide to go back to the 19th century, or skip down to the 21st century.

21st Century Diet

Go to a specialty foods store and start cruising the aisles. You'll find many foods labeled gluten-free. Some gluten-free foods have even found their way to mainstream grocery store shelves. (Foods from outside the United States labeled gluten-free may contain a small amount of gluten, so stick with foods made in America.)

If you eat a lot of pasta, you're in luck. Rice pasta tastes very much like wheat pasta. Potato-rice pasta is passable, though a bit mushy. Don't get quinoa-corn pasta; quinoa may not be entirely safe for someone with celiac disease.

Bread lovers don't have it as easy. Gluten is an elastic protein that gives bread its structure. Gluten-free breads are dense and heavy. Our advice: Don't eat bread for the first week or so. Then the beans-on-a-camping-trip phenomenon will set in. By the second or third week, you'll be craving any bread, and gluten-free breads might not seem so bad. Actually, Ener-G Tapioca Loaf makes good French toast.

If you're a nut for cookies and start to feel deprived, try Pamela's Chunky Chocolate Chip Cookies. They have so much chocolate you'll barely notice they're gluten- and dairy-free.

Web Resources for Diabetes and Celiac Disease

No Matter Which Century

Keep lactose low. The damage to the intestine in celiac disease often leads to lactose intolerance, which means you aren't able to digest the type of sugar found in milk and other dairy products. The symptoms are diarrhea and gas.

Keep your lactose consumption low or nonexistent during this trial. If you want to keep consuming milk and milk products, you can buy lactose-reduced milk (in the dairy case next to all the other milk), lactase drops (add the drops to regular milk), or over-the-counter lactase caplets or chews (in your grocery store or pharmacy, near other digestive aids).

Consider less variety. Consider eating the same thing frequently, for example, gluten-free pancakes every morning. (Arrowhead Mills makes a good gluten-free pancake mix.) One, you'll soon learn how your blood sugar levels are going to be affected by the new foods. (Check your blood sugars often during your gluten-free trial.) Two, if it turns out you are not sensitive to gluten, you won't have a bunch of partially-used gluten-free foods left over at the end of your experiment.

Pay attention to carb counts. Read the Nutrition Facts labels to get carb counts. Don't assume a sandwich made with gluten-free bread has the same amount of carbohydrate as one made with your usual bread.

Avoid alcohol. Alcohol made from grain (beer, for example) contains gluten. Consider avoiding alcohol during this trial. Alcohol can have unexpected effects on your blood sugar levels, and you'll have enough going on during this trial as it is.

Feeling Better?

It may take two to four weeks of a strict gluten-free diet before you start to feel better, though some people feel better within days. After you feel better, don't "challenge" your body by eating a large amount of wheat to see what happens. If you do have celiac disease, you could end up sicker than you were before.

As soon as you start to feel better, see your doctor and get a referral to a gastroenterologist. Blood tests that show whether you react to gluten may now be negative, because you've been off gluten. If you wait too long and your small intestine starts to heal, a biopsy may not be as clear cut as if you had seen a doctor while you were still eating gluten, so don't delay seeing a doctor.

Taken from the October 2001 issue of Diabetes Forecast. Written by Marie McCarren, a writer and editor in Arnold, Md. Jean Guest, MS, RD, a graduate research assistant at the University of Nebraska at Lincoln, provided invaluable assistance with this article.

Source: American Diabetes Association


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